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Plan B Conversations & Low Communication Skills

Teenage girl in difficult mood with a foster parent

Think:Kids’s Collaborative Problem Solving® (CPS) approach is a way of communicating with a youth that helps strengthen their problem solving skills and aids emotional regulation and cognitive development. It’s a way to work together to solve a problem in what is called a Plan B conversation, rather than an authority figure prescribing or dictating solutions. 


Plan B conversations are a valuable tool for working together with your foster youth to solve the problem underlying a difficult behavior.  But what happens to the conversation when conversations in general are a problem area? How do we apply the CPS model for youth who are young or delayed, non-verbal, or struggling with language skills? 


Developmental Appropriateness


It’s not always reasonable to expect youth to be good at talking out their problems. Consider their developmental age, whether they understand what’s expected of them, and how going from regulated to dysregulated might affect their skills. 


The thinking skills necessary for solving problems, remaining flexible, and tolerating frustration fall into five categories:


  • Language and communication (e.g. following conversations, expressing themselves in words)

  • Attention and working memory (e.g. doing things in order, tuning out irrelevant stimuli, processing multiple thoughts, ideas, or possible solutions to a problem at once) 

  • Emotion- and self-regulation (e.g. thinking rationally while frustrated; thinking before they speak; calming down after getting upset; falling asleep or waking up; staying seated during class or meals)

  • Cognitive flexibility (e.g. transitioning between tasks; thinking hypothetically; handling uncertainty or novelty; interpreting information without over-generalizing or taking things personally; handling changes from rules, routines, and original plans)

  • Social thinking skills (e.g. noticing and accurately interpreting verbal and nonverbal social cues; seeking attention in appropriate ways; understanding how they are perceived by or how their behavior affects others; considering others’ perspectives or points of view)


Social, emotional, and behavioral challenges crop up in youth when some of these skills are lagging behind what would be considered age-appropriate, either across the board or just when dysregulated. With these youth, you have to meet them where they are to engage those lagging skills and give the youth more opportunities to practice them in a safe, non-judgmental space. That's how you help build skills up over time until those challenges go from huge hurdles to manageable bumps in the road. 


So. You’ve taken the youth’s skills into account. You know that your youth might not or will not be able to answer clarifying questions you have. How do you cut through this Gordian Knot to the heart of the problem and figure out what’s really going on with them?


This is where Plan B becomes less conversation and more interaction. 


A youth's shoelaces tied together, with overlaying text that reads "Gordian Knot: an intricate problem, insoluble on its own terms."

Wordless Approach: the Silent Plan B


Say you’re working with a youth who has trouble sitting still during and following when you explain your concerns at the start of a Plan B conversation. Say they misinterpret your clarifying questions and get frustrated, lashing out. The lagging skills here are likely in language and communication, emotion- and self regulation, and cognitive flexibility. 


You want to meet this youth where they are, but where do you even start? 


A silent Plan B starts, as all Plan Bs do, with coming up with ideas for what’s behind the youth’s behavior. This perspective-taking is important, even when the youth is able to engage in a Plan B conversation a bit more. 


Put yourself in their shoes and try to answer these questions:


  • If I were them, what could my worry or concern about the situation be?

  • What part of the situation are they struggling with?

  • Remember to focus on the youth’s concerns rather than their behaviors.


Answers are based on what you observe, and once you have your guesses it’s more of the same. Try moving to a different part of the room for an activity and see how the youth responds, and if that gives you some idea of what they might need. When you walk closer to them do they respond by showing that they want space or do they seem to appreciate that you are coming closer? 


Visual cues can be just as useful as verbal ones, especially when it comes to neurodivergence. For some youth who are neurodivergent, their brains process and think better with visual cues as opposed to verbal. Using graphics and drawings can be especially helpful for these youth. 


Paying attention to all these non-verbal details will help refine your Plan B, silent or otherwise. Instead of words, you’re asking clarifying questions and “listening” for the answers through body language and emotional regulation. 


A Dysregulated Mind Struggles More


When regulated, our expectations for the youth might be reasonable. 


When dysregulated, some or all skills can drop away and those expectations become unrealistically high. A calm mind can think abstractly and an alert mind concretely, but an alarmed mind responds emotionally, a fearful mind reactively, or a terrorized mind reflexively. 


Youth with trauma history are always a step closer to alarmed, fearful, or terrorized. Whether that trauma is generational or otherwise, the things they’ve been through have made the paths to those states a familiar one. It's the worst times to try having a Plan B conversation; your questions would come when the youth’s brain isn’t fully online to answer. 


We cannot stress this enough: you cannot reason a youth into regulation.


So, How Do We Help Regulate?


There are ways to adjust the environment around the youth to give them a little more support. These accommodations help promote regulation, and sometimes need to be provided in small doses throughout the day to help ward off getting too overwhelmed. 


For youth with higher sensory needs, that overwhelm can sometimes feel like wanting to crawl out of their own skin and that is very hard to think around. Try offering the youth:


  • Sensory input they enjoy (e.g., sounds, touch, lighting, smells, tastes, movement, etc.)

  • Opportunities for sensory deprivation when input gets to be too much

  • Reflective listening, so they can feel heard

  • Reassurance, because they don’t have to earn accommodations (being met where they are), they need them


Offering these things during your Plan B can help keep the youth grounded enough to better engage with you and take part in the conversation. 


Check against your assumptions to make sure you’re on the right track with pauses summarizing what you think they’ve said. Then ask, “Am I right? Is this what you’re saying?” If not, “Okay, thanks for letting me know!” Make sure to clearly communicate that you are trying to understand, and still holding that space without judgment. 


For kids with very low language skills, this takes a lot of time and patience. Let them know they can disagree without automatically being wrong or getting in trouble. Keep up that reflective listening, emphasizing that your guesses about what they feel and why they do things aren’t always right. After significant trauma it can take a long time to adjust to a supportive environment, but stay patient! Keep reassuring them and backing that reassurance up with your actions.


You might have a conversation as simple as drawing together, especially with a young or nonverbal youth. Ask them to draw how they feel about something. Then let them draw something they want to draw. Then bring it back to that feeling, or a clarifying question about it, with a guess about why they feel that way and a drawing of your own. The activity allows for separation from what they’re struggling with; they’re not confronting the feeling directly, they’re drawing a picture of what that feeling looks like. 


Overall, one of the best things you can do to help a youth stay regulated is to model that yourself. If you’re getting to a point in your Plan B where your regulation is slipping, it might be time to Plan C it; be thoughtful and intentional when you drop the subject to return to at a later time. This is advice for when you’re at your limit for the day and can’t power struggle the issue anymore. 


And remember: any engagement in a Plan B conversation with a youth, even if you don't get to a solution, is building skills!


Learning More


GOBHI foster parents have access to a wealth of resources on this topic and more. 


All the information above was covered in our most recent monthly Foster Parent Power Hour by guest speaker Randi Cooper, who is a behavior consultant, special educator, and trainer with over 20 years experience working with individuals who experience challenging behaviors. Randi is an expert in Collaborative Problem Solving and is a staff member of Think:Kids at Massachusetts General Hospital in Boston as a Clinical Trainer and Consultant. 


Current foster parents can access a recording of the session in the shared resources drive under “Recorded Power Hours.” For more on sensory needs, check out the October 2023 recording in the same folder, and more PDFs and articles on sensory needs in the “Extra Resources” folder.



For those of you who aren’t foster parents but are interested in beginning that journey, let us know! Begin your application for full-time or respite care today, join an upcoming virtual Information Session, email fostercareinfo@gobhi.com, or call (541) 256-4587.


The Collaborative Problem Solving® approach is owned and developed by Think:Kids (www.thinkkids.org), a program based in the Department of Psychiatry at the Massachusetts General Hospital in Boston, MA.


 

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